![]() An encouraging follow-up studyĪn earlier landmark study conducted elsewhere, called the Preschool ADHD Treatment Study (PATS), found that treatment with the stimulant methylphenidate significantly reduced ADHD symptoms in children between the ages of 3 to 5.5 years. “The fact is that children taking the A2As had fewer difficulties with these side effects,” says Harstad. Increased skin picking/repetitive behaviors (11 percent vs.increased stomachaches (13 percent vs.moodiness/irritability (50 percent vs.The most common negative effects between stimulants and A2As were: “However, for stimulants, there were several side effects that were reported more frequently than for the kids that had been initiated on A2A medication,” says Harstad. Lower rate of side effects with A2Asĭaytime sleepiness was the only adverse side effect that developed more frequently in children who were started on A2As compared with stimulants (38 percent vs 3 percent). Specific behavioral techniques include: positive reinforcement, timeouts, response cost (withdrawing rewards or privileges when unwanted or problem behavior occurs), and token economy (a combination of positive reinforcement and response cost). – using calm discipline (such as timeouts, distraction, and removing the child from the situation). – finding activities in which the child can be successful (such as hobbies and sports) ![]() – using charts and checklists to help the child stay “on task” – identifying unintentional reinforcement of negative behaviors – providing specific and logical places for the child to keep schoolwork, toys, and clothes They can include modifications in the physical and social environment that are designed to change behavior using rewards and nonpunitive consequences. Of the 497 children in the study, 309 (62 percent) had first received behavioral therapy before initiating ADHD medication, in line with current ADHD treatment recommendations from the American Academy of Pediatrics.īehavioral interventions are the first treatments recommended for ADHD in preschool-age children. ![]() The median age of the children in the study was just over 5 years old 82 percent were male. “Since these kids are already being prescribed these drugs, it was important to study their effectiveness and possible adverse effects.” “We found that about 35 percent of preschool-age children with ADHD began drug treatment with A2A medications, even though little is known about their effectiveness and safety in this age group,” says lead author Elizabeth Harstad, MD, MPH, of the Division of Developmental Medicine at Boston Children’s. One-third of children already taking A2A medicationsĪ team from the Developmental Behavioral Pediatrics Research Network (DBPNet), which includes Boston Children’s, reviewed the medical records of nearly 500 children seen at seven outpatient developmental-behavioral pediatric practices. It is the first analysis of the effects of both stimulants and A2As in preschool children. Results of this ADHD/A2A study are published in JAMA. Just as important, the study shows that these medications have fewer side effects than stimulants, like methylphenidate (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse), which are often the first line of ADHD treatment.Ī2As were initially used to regulate blood pressure in adults but then gained FDA approval to treat ADHD in school-aged children after clinical trials found they could improve attention and focus and reduce ADHD symptoms. But what if symptoms linger, or are so severe that they interfere with a child’s social, emotional, and educational development?Ī study from Boston Children’s Hospital finds that starting drug treatment with alpha-2-adrenergic agonists (A2As), such as guanfacine and clonidine, can be effective in reducing ADHD symptoms in preschool-age children. For these children, behavioral interventions intended to redirect a child or otherwise replace negative behaviors with positive ones are the first line of treatment. (Image: Adobe Stock/Illustration: Sebastian Stankiewicz, Boston Children's)Ībout 2.4 percent of preschool-age children have an attention-deficit/hyperactivity disorder (ADHD) diagnosis. A study comparing two types of ADHD medications in preschool-age children shows alpha-2-adrenergic agonists like guanfacine and clonidine are effective in reducing ADHD symptoms but with a lower rate of side effects.
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